Dedicating the right resources to denials management: full-time physician attention helped reduce one health system's denied claims and length of stay.(Feature Story) From: Healthcare Financial Management | Date: December 1, 2003| Author: Baumel, Mark J.; Corrato, Robert R. | COPYRIGHT 2003 Healthcare Financial Management Association. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group.Copyright information

In early 2000, Conshohocken, Pa.-based Mercy Health System decided to carefully evaluate the rate at which its managed payers were denying payment of claims. Mercy's leaders learned that the organization was experiencing a denial and downgrade rate of 25.4 percent for managed care medical/surgical days, excluding particular services such as obstetrics or behavioral health, amounting to $13.3 million each year in lost revenue to the system. They realized that in addition to having a ...